A manual of modern surgery : an exposition of the accepted doctrines and approved operative procedures of the present time, for the use of students and practitioners . e-cially if made by a projectile travelling with a comparatively moderatevelocity, differ in appearance. The former is small and has depressed G UNSHO T WO UNDS. 131 and regular edges, stained, perhaps, with grease and powder. Thewound of exit has everted, ragged margins, not stained, and is muchlarger than that of entrance, because the skin has no external supportwhen it receives the impact from within. Conical bullets discharg
A manual of modern surgery : an exposition of the accepted doctrines and approved operative procedures of the present time, for the use of students and practitioners . e-cially if made by a projectile travelling with a comparatively moderatevelocity, differ in appearance. The former is small and has depressed G UNSHO T WO UNDS. 131 and regular edges, stained, perhaps, with grease and powder. Thewound of exit has everted, ragged margins, not stained, and is muchlarger than that of entrance, because the skin has no external supportwhen it receives the impact from within. Conical bullets dischargedby rifled arms travel with such velocity that these distinctions are notoften present. A bullet may traverse the tissues in a direct line, be deflected bybones or fascias, or be split against a bone and make several openingsof exit. Instances are recorded where the bullet has taken a circularcourse and been found imbedded near the wound of entrance. Por-tions of clothing or wadding carried into the wound act as compli-cations. Small shot fired at short range, say a foot or two, will makea single wound of entrance because there has been no scattering. Fig. Skiagraph of bullet wound of elbow-joint. Removal by incision with restoration of function. [Authors Case.] Powder alone may, if discharged near the skin, produce a seriousinjury. In any event, if unburnt powder enters the skin there willbe permanent discoloration like tattooing, unless the grains are dis-charged by suppuration or removed by the surgeon. The shock,hemorrhage, and the other symptoms of gunshot wounds correspondwith injuries of similar gravity produced by other vulnerating treatment consists in removing the foreign body as soon asreaction is established, provided it can be done without seriously in- 132 SHOCK, FAT EMBOLISM AND WOUNDS. creasing the danger. Skiagraphy has been of great service in locatingbullets in the tissues. The injury has been produced by the entranceof the projectile, and it
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